Individual
DAVID LEE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED MASSAGE THE
Contact information
Practice address
6850 MINERAL RIDGE DR, EL PASO, TX 79912-7693
(503) 330-6609
Mailing address
6850 MINERAL RIDGE DR, EL PASO, TX 79912-7693
(503) 330-6609
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT125547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT125547
STATE OF TEXAS
TX
Enumeration date
03/14/2019
Last updated
03/14/2019
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